title: Stereotactic radiosurgery for brain metastases from hepatocellular carcinoma.
abstract: The purpose of this study is to investigate the possible role of stereotactic radiosurgery (SRS) in the management of patients with brain metastases from hepatocellular carcinoma (HCC). Thirty-two consecutive patients with 80 brain metastases from HCC were treated with SRS. Twenty-eight (87.5 %) patients were male, and the mean age of the patients was 54 ± 12 years (range 22-73). Twenty-seven (84.4 %) patients were classified as RTOG RPA Class 2. The mean tumor volume was 6.14 ± 11.3 cm(3) (range 0.01-67.3). The mean marginal dose prescribed was 20.1 ± 3.6 Gy (range 10.0-25.0). The median overall survival time after SRS was 11.3 ± 5.8 weeks (95 % CI 0-22.7). A greater total volume of brain metastases (>14 cm(3)) was the only independent prognostic factor (HR = 2.419; 95 % CI 1.040-5.624; p = 0.040). The actuarial control rate of brain metastases was 51.3 % at 4 months after SRS. The prescribed marginal dose (>18 Gy) was significantly related with the actuarial tumor control (HR = 0.254; 95 % CI 0.089-0.725; p = 0.010). The prognosis of patients with brain metastases from HCC is dismal even with the modern technology of radiosurgery. The marginal dose prescribed should be reevaluated to improve upon the current poor local control rates.
authors.affiliation: Department of Neurosurgery, Seoul National University Bundang Hospital, Gyeonggi-do, Seongnam, Korea.
authors.forename: Jung Ho
authors.initials: JH
authors.lastname: Han
authors.forename: Dong Gyu
authors.initials: DG
authors.lastname: Kim
authors.forename: Hyun-Tai
authors.initials: HT
authors.lastname: Chung
authors.forename: Sun Ha
authors.initials: SH
authors.lastname: Paek
authors.forename: Chul-Kee
authors.initials: CK
authors.lastname: Park
authors.forename: Chae-Yong
authors.initials: CY
authors.lastname: Kim
authors.forename: Young-Hoon
authors.initials: YH
authors.lastname: Kim
authors.forename: Hee-Won
authors.initials: HW
authors.lastname: Jung
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D011379:Prognosis; D016634:Radiosurgery; D015996:Survival Rate; D055815:Young Adult